Ambulatory pH monitoring

More definitive diagnostic tests include endoscopy (via endoscope or Pillcam ESO capsule), 24-hour ambulatory pH monitoring, diagnostic proton pump inhibitor (PPI) administration, or esophageal manometry. 

Hour ambulatory pH monitoring may be the only way to objectively prove that symptoms are reflux-related in patients with atypical symptoms or non-erosive reflux disease. Ambulatory pH monitoring may also be useful in patients whose symptoms are not improving on adequate doses of acid-suppressing therapy. 

The empiric use of a standard-dose (or double-dose) PPI as a therapeutic trial may be used in diagnosing GERD. This approach is less expensive, more convenient, and more readily available than ambulatory pH monitoring. Problems with this diagnostic approach include lack of a standardized dosing regimen and duration of the diagnostic trial. 

Hour ambulatory pH monitoring A test that quantifies the amount of acid that refluxes into the esophagus over 24 hours under ambulatory (outpatient) conditions. 

S. Harrell, B. Evans, S. Goudy, W. Winstead, E. Lentsch, J. Koopman, and J.M. Wo, Design and implementation of an ambulatory pH monitoring protocol in patients with suspected laryngopharyngeal reflux. Laryngoscope 115, 89—92. (2005)... 

Barium radiography is less expensive than endoscopy but lacks the sensitivity and specificity needed to accurately determine the presence of mucosal injury or to distinguish Barrett s esophagus from esophagitis. Twenty-four-hour ambulatory pH monitoring is useful in patients who continue to have symptoms without evidence of esophageal damage, patients who are refractory to standard treatment, and patients who... 

Omeprazole given empirically in standard or double doses as a therapeutic trial for diagnosing GERD may be as beneficial as ambulatory pH monitoring while also being less expensive, more convenient, and more readily available. However, there is no standard dosing regimen standard-dose or double-dose omeprazole has been used. 

The Bernstein test, another procedure used to measure gastric fluid pH, is less expensive than ambulatory pH monitoring. This procedure requires inserting a nasogastric (NG) tube and administrating... 

Wiener GJ, Koufan JA, Wu WC et al (1989) Chronic hoarseness secondary to gastroesophageal reflux disease documentation with 24-hr ambulatory pH monitoring. Am J Gastroenterol 1503-1508... 

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